Five-star quality rating system

CMS will begin publicly reporting six new quality measures

During the March 3rd Skilled Nursing Facility/Long-term Open Door Forum, it was announced that starting in April, the Centers for Medicare and Medicaid Services will begin publicly reporting six new quality measures (QMs)—four short-stay measures (three claims-based and one MDS-based) and two MDS-based long-stay QMs—on the  Nursing Home Compare site. Then beginning in July, five of those six new QMs will begin to be phased-in to the Five Star Quality Rating System until they are fully incorporated effective in January 2017.

The new quality measures include:

Three sets of Medicare claims-based measures for short-stay residents, based on:

  • Readmission
  • ED visit
  • Discharge to community

CMS also will have two long-stay MDS measures and one short-stay MDS measure. These include:

  • percentage of long-stay residents (100 days or less) who are on anti-anxiety medication or hypnotic medication
  • percentage of long stay residents whose ability to move about independently, whether by walking or wheelchair, gets worse
  • percentage of short-stay residents who’ve made improvements in their function

Five of the measures will be incorporated into the five-star quality rating system, phased in starting in July (all except the percentage of long-stay residents on anti-anxiety medication or hypnotic medication). From April to July the measures will be posted on Nursing Home Compare publicly, but not be part of the five-star quality calculation.

Each nursing home will receive, in the normal provider preview process CMS has been using under to the five-star rating system, an advance look at their nursing home numbers. That advance look will be included in the April update. CMS will give providers an idea of the impact on the quality measure rating in July, but until then, will include the most current numbers that providers can see how they rate relative to national standards.